Abstract
Psoriasis is a chronic inflammatory multisystem disease involving skin and joints affecting 1–3 % of the world population. The 308-nm excimer laser has been recently used in the treatment of psoriasis, especially localized psoriasis of scalp and palm and soles. The objective of the study is to evaluate the therapeutic efficacy and safety of a 308-nm excimer laser for the treatment of scalp and palmoplantar psoriasis. A total of 41 adult patients (25 males and 16 females) were enrolled in this study, of which 26 patients had lesions localized to scalp, and 15 patients had involvement of palm and soles. The mean age was 44.5 years (range 18–73). And, the mean duration of psoriasis in our patients was 15 years. They were treated with a 308-nm excimer laser. The initial dose was based on multiples of a predetermined minimal erythema dose, twice weekly for a maximum 12 weeks. Twenty-two of the 23 patients with scalp psoriasis showed improvement, while one patient showed no change; none experienced worsening of symptoms. The mean minimal erythema dose (MED) was found to be 383 mJ/cm2 (range 180–650 mJ/cm2). The cumulative dose of irradiation was 1,841 mJ/cm2 (range 600–2,500). The percentage improvement from baseline in PSSI score was 78.57 %. Side effects were seen in 20 patients (86.96 %) mainly in the form of erythema. Four patients developed mild relapse at the end of 6 months after the therapy. In 15 patients with palmoplantar psoriasis, the mean MED was found to be 415 mJ/cm2 (range 200–950 mJ/cm2). The cumulative dose of irradiation was 28.4–115.5 J cm2 (mean 59.1 J cm2). The mean number of treatments to achieve clearance (equal to 90 % reduction of PSI score) was 16. Two patients relapsed at the end of 6 months after the therapy. The 308-nm excimer laser is an effective, safe, easy, and relatively quicker method for the treatment of psoriasis at difficult to treat sites, with good results in a somewhat short time.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Raychaudhuri SP, Farber EM (2001) The prevalence of psoriasis in the world. J Eur Acad Dermatol Venereol 15:16–17
Van Voorhees AS, Fried R (2009) Depression and quality of life in psoriasis. Postgrad Med 121(4):154–161
Al-Mutairi N, Al-Farag S, Al-Mutairi A, Al-Sheltawy M (2010) Comorbidities associated with psoriasis: an experience from the Middle East. J Dermatol 37(2):146–155
Wozel G (2008) Psoriasis treatment in difficult locations: scalp, nails, and intertriginous areas. Clin Dermatol 26:448–459
Taneja A, Racette A, Gourgouliatos Z, Taylor CR (2004) Broad-band UVB fiber-optic comb for the treatment of scalp psoriasis: a pilot study. Int J Dermatol 43:462–467
Mysore V (2009) Targeted phototherapy. Indian J Dermatol Venereol Leprol 75:119–125
Richards HL, Fortune DG, O’Sullivan TM, Main CM, Griffiths CE (1999) Patients with psoriasis and their compliance with medication. J Am Acad Dermatol 41:581–583
Han L, Somani AK, Huang Q, Fang X, Jin Y, Xiang LH et al (2008) Evaluation of 308-nm monochromatic excimer light in the treatment of psoriasis vulgaris and palmoplantar psoriasis. Photodermatol Photoimmunol Photomed 24:231–236
Morison WL, Atkinson DF, Werthman L (2006) Effective treatment of scalp psoriasis using the excimer (308 nm) laser. Photodermatol Photoimmunol Photomed 22:181–183
Goldberg DJ, Chwalek J, Hussain M (2011) 308-nm Excimer laser treatment of palmoplantar psoriasis. J Cosmet Laser Ther 13(2):47–49
Gattu S, Rashid RM, Wu JJ (2009) 308-nm excimer laser in psoriasis vulgaris, scalp psoriasis, and palmoplantar psoriasis. J Eur Acad Dermatol Venereol 23:36–41
Hofer A, Fink-Puches R, Kerl H, Quehenberger F, Wolf P (2006) Paired comparison of bathwater versus oral delivery of 8-methoxypsoralen in psoralen plus ultraviolet: a therapy for chronic palmoplantar psoriasis. Photodermatol Photoimmunol Photomed 22:1–5
Farley E, Masrour S, McKey J, Menter A (2009) Palmoplantar psoriasis: a phenotypical and clinical review with introduction of a new quality-of-life assessment tool. J Am Acad Dermatol 60:1024–1031
Pettey AA, Balkrishnan R, Rapp SR, Fleischer AB, Feldman SR (2003) Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice. J Am Acad Dermatol 49:271–275
Hamzavi I, Kerr HA (2009) Phototherapy and laser for the treatment of mild-to-moderate psoriasis. In: Koo JY, Lee CS, Lebwohl MG (eds) Mild-to-moderate psoriasis, 2nd edn. Informa Healthcare, New York, pp 103–128
Goldinger SM, Dummer R, Schmid P, Vavricka MP, Burg G, Lauchli S (2006) Excimer laser versus narrow-band UVB (311 nm) in the treatment of psoriasis vulgaris. Dermatology 213:134–139
Kollner K, Wimmershoff MB, Hintz C, Landthaler M, Hohenleutner U (2005) Comparison of the 308-nm excimer laser and a 308-nm excimer lamp with 311-nm narrowband ultraviolet B in the treatment of psoriasis. Br J Dermatol 152:750–754
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Al-Mutairi, N., Al-Haddad, A. Targeted phototherapy using 308 nm Xecl monochromatic excimer laser for psoriasis at difficult to treat sites. Lasers Med Sci 28, 1119–1124 (2013). https://doi.org/10.1007/s10103-012-1210-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10103-012-1210-4